Compliance Auditor

  • location: Woodland Hills, CA
  • type: Permanent
  • salary: $60,000 - $90,000 per year

job description

Compliance Auditor

Seeking an experienced Compliance Auditor for a direct hire opportunity working for a Health Insurance Company in the Woodland Hills area! Position Purpose:  Perform operational and compliance risk based audits for the health plan. Qualification/Skills:  -Bachelor's degree in, Business, Accounting, Finance, Healthcare related field or equivalent experience  -2+ years of compliance experience, preferably with State or Federal managed care programs Location: Woodland Hills, CA Hours: Mon-Fri 8am-5pm Salary: DOE  

Responsibilities

-Develop schedule and perform health plan audits and specialty care company (subcontractor) audits

-Evaluate processes and performance through audits for scalability, effectiveness, and risk mitigation
-Provide written audit documentation regarding state and/or federal managed care programs and process audit observations
-Review and analyze responses to audit observations and findings and facilitate corrective action plans
-Facilitate Health Plan and specialty care company (subcontractor) compliance through corrective action process.

- Identify, develop and implement corrective actions and training materials to improve program performance based on audit outcomes
-Provide education and training to internal and external entities as needed on programs, compliance, and fraud, waste and abuse
-Serve as a resource related to the health plan and specialty care company (subcontractor) programs



Skills

  • Compliance (2 years of experience is required)
  • Managed Care (2 years of experience is required)
  • Health Plan Audits
Education
  • Bachelors
Qualifications
  • Years of experience: 3 years
  • Experience level:Experienced
Shift: First

Working hours: 8 AM - 5 PM

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EEO Employer: Race, Religion, Color, National Origin, Citizenship, Sex, Sexual Orientation, Gender Identity, Age, Disability, Ancestry, Veteran Status, Genetic Information, Service in the Uniformed Services or any other classification protected by law.

San Francisco Fair Chance Ordinance:

Qualified applicants in San Francisco with criminal histories will be considered for employment in accordance with the San Francisco Fair Chance Ordinance.


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